Polysomnogram?

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curiousgeorge
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Polysomnogram?

Postby curiousgeorge » Mon Dec 07, 2015 1:35 am

My doctor wants to send me for a polysomnogram. Do I need it?

(Asked by a patient)

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bachjr
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Re: Polysomnogram?

Postby bachjr » Mon Dec 07, 2015 1:37 am

Polysomnography is used to assess for sleep disordered breathing for people with normal breathing function and muscle strength who snore and have central and obstructive events during sleep. Sleep disordered breathing is treated by using CPAP and bi-level PAP and their effectiveness is established by polysomnography. Apneas and hypopneas are “titrated away” by changing CPAP or bi-level PAP settings during polysomnography. This is fundamentally different from fully resting and supporting inspiratory muscles by using ventilators at full support settings (NVS).

After performing polysomnography for respiratory muscle weakness, CPAP and O2 are often prescribed even though they are useless and the latter can be harmful. Often, bi-level PAP is prescribed at less than the full support settings needed to rest muscles during sleep so that breathing and energy can be better during the day.

Therefore, polysomnography is not warranted for people with respiratory muscle weakness. However, polysomnograms are well compensated financially whereas there are no insurance codes for reimbursing simple sleep oximetry and carbon dioxide monitoring, which is at times all that is usually needed.

JB
John R. Bach MD
Medical Director, VentilaMed BreatheNVS
Medical Director, Center for Ventilator Management Alternatives
Professor of Physical Medicine and Rehabilitation, Professor of Neurology, Rutgers New Jersey Medical School


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